title: Stepwise approach to laparoscopic hysterectomy: evaluation of technique and cost benefit.
abstract: This article examines factors associated with performing a laparoscopic hysterectomy in a stepwise fashion and addresses the technique and cost effectiveness of this procedure compared with abdominal hysterectomy. We review techniques of the laparoscopic hysterectomy as well difficulties that may be encountered throughout the procedure. The hysterectomy is profiled in a method that provides a reproducible system that allows surgeons to increase their surgical numbers and comfort level. When assessing cost-benefit analysis, the cost of hysterectomy is primarily influenced by the operative time, length of hospital stay, equipment, and complications. Robotic and laparoscopic hysterectomy had the highest mean hospital charges. The laparoscopic approach to hysterectomy provides better rates of recovery, length of stay, and hospital cost. The use of the stepwise approach to hysterectomy may allow surgeons to readily perform the procedure and also identify areas and techniques that need improvement. Regardless of age, body mass index (BMI), comorbities, and other nonclinical factors, the laparoscopic hysterectomy compared with abdominal hysterectomy and vaginal hysterectomy has been shown to be better for the patient's recovery and quality of life.
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine Chicago, Illinois.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Shepherd
authors.affiliation: Gratis Faculty University of Louisville Owensboro, Kentucky.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Hudgens
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health University of Louisville School of Medicine Louisville, Kentucky.
authors.forename: Marvin A
authors.initials: MA
authors.lastname: Yussman
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health University of Louisville School of Medicine Louisville, Kentucky.
authors.forename: Shan M
authors.initials: SM
authors.lastname: Biscette
authors.affiliation: Department of Obstetrics, Gynecology, and Women's Health University of Louisville School of Medicine Louisville, Kentucky.
authors.forename: Resad
authors.initials: R
authors.lastname: Pasic
mesh_terms: D003362:Cost-Benefit Analysis / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D007044:Hysterectomy / Q000191:economics* / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000191:economics* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics* / Q000706:statistics & numerical data; D018803:Models, Economic; D061646:Operative Time; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology